MADISON -- Wisconsin’s Catholic bishops have released the third edition of their pastoral letter on end-of-life health care decision-making and advance care planning, Now and at the Hour of Our Death.

The letter voices the bishops' concern and compassion for those facing critical health care decisions, and shares a moral and ethical framework for making such decisions.

Popular document

"The conference issued the first edition of this pastoral statement in 2002. That edition and the second one issued in 2006 have proven to be our most frequently requested document," explained Wisconsin Catholic Conference (WCC) Executive Director John Huebscher.

"In the seven years since the second edition, we have seen even greater interest in the moral questions surrounding death and dying. The bishops are resolved to keep responding to that interest. Reissuing the document is an effective way to do that."

Advances in technology

The pastoral letter opens by acknowledging that advances in medical technology create both opportunities and moral challenges. As medicine continues to strive to preserve human life, scientific progress poses new ethical questions regarding the meaning of life and death.The letter offers guidance to those who face a serious illness and to those who are seeking to prepare in advance for their medical care. It addresses the challenges faced by society today, noting the mounting threat of assisted suicide and euthanasia.

The document also provides guidance on the Church’s teaching regarding various treatment measures, such as life support, nutrition and hydration, pain management, and overly aggressive medical treatment.

Incorporates changes

The third edition incorporates a number of changes from earlier editions, including an updated reference to the "Ethical and Religious Directives for Catholic Health Care Services" (ERDs), the fifth edition of which was distributed by the United States Conference of Catholic Bishops (USCCB) in 2009. Since the fifth edition of the ERDs includes a clarification on providing patients with nutrition and hydration, the third edition of the Wisconsin bishops' letter now reflects this change.

Now and at the Hour of Our Death also offers additional guidance on the use of advance directives, with specific reference to the increasing use of Physician Orders for Life-Sustaining Treatment (POLST) in Wisconsin.

The bishops caution against the use of POLST, citing their July 2012 pastoral letter, Upholding the Dignity of Human Life. The bishops have consistently encouraged Catholics to engage in advance care planning and recommended the preparation of a power of attorney for health care. Other changes include an expanded glossary and listing of resources.

Viewed through moral lens

The bishops emphasize that the medical decisions we face have moral dimensions. "Choices regarding medical treatments must be viewed through a moral lens that guides us away from choices that deny human dignity and toward choices that affirm our respect for all life and our belief in eternal life," Huebscher noted.

Throughout the letter, the bishops stress the importance of contemplating questions regarding care in light of Church teaching before a crisis occurs. The letter encourages family members to discuss the reality of illness and death. "You may find it difficult to bring up the subject with your loved ones," the bishops acknowledge in the pastoral. However, they affirm that "These conversations are vitally important for you and those you love."

Caring for the sick

In addition, the bishops focus on the critical role that the faith community can and should play in the care and comfort of the sick and their loved ones. They encourage parishes to work collaboratively with hospitals and hospice programs to provide spiritual and emotional support to the dying.

"Often when the issue of end of life decision-making is addressed, a great deal of focus is placed on the questions and concerns regarding health care or medical decisions. However, these issues should not overshadow the importance of providing spiritual support to the dying person."

An electronic version of the pastoral is available at www.wisconsincatholic.org Printed copies will soon be released and available from local diocesan respect life or social concerns offices.

A free copy can also be obtained by contacting the WCC at 608-257-0004 or
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(multiple copies will include a shipping fee). This summer, the WCC will also release a Spanish language version of the document.